Table 3. Problem and Solution of Alert Override, Fatigue, and Burnout.

	Override	Fatigue	Burnout
Problem	A growing number of inappropriate alert overrides often puts patients at risk of fatal adverse drug events.38,39 Physician override rates raise concerns about the effectiveness of CDSSs in many implementations.40,41 Override rates decrease significantly as patient severity increases.42	Lower specificity and ambiguous alert contents are associated with overrides and alert fatigue.43,44 Alert-related fatigue and physician burnout are very frequent among emergency physicians, which cause concern regarding the performance of a CDSS.45,46,47	The majority of physicians and learners attribute EMR to their symptoms of burnout, even when they did not identify as being burned out.48 Burnout leads to reduced quality of care49 and medical errors.50 Lower satisfaction and higher frustration with the EMRs are significantly associated with perceptions of EMR contributing toward burnout.48
Solution	Alert override patterns have focused on specific disease or alert types.51,52,53 Systems should be implemented to enable analysis based on grade and potential harm and provide clear recommendations.54 Suggested turning off frequently overridden alerts,55 updating clinical content, and the need for consensus meetings between physicians and pharmacists.56	Optimize alert types and frequencies to increase clinical relevance so that important alerts are not overridden inappropriately.57 Machine learning algorithms were used to reduce alert fatigue by identifying physicians and departments who override alerts.58 Identification of physicians and departments who override alerts will help increase benefits.58	The impact of proficiency training leads to significant improvement in satisfaction, which could eventually reduce burnout.59 Human-centered approach to physician burnout by reducing unnecessary administrative burdens.48,60